Arrhythmia-Induced Cardiomyopathy: JACC State-of-the-Art Review

Research output: Contribution to journalReview article


External Institution(s)

  • Virginia Commonwealth University
  • VA Medical Center


Original languageEnglish (US)
Pages (from-to)2328-2344
Number of pages17
JournalJournal of the American College of Cardiology
Issue number18
StatusPublished - May 14 2019


Arrhythmias coexist in patients with heart failure (HF) and left ventricular (LV) dysfunction. Tachycardias, atrial fibrillation, and premature ventricular contractions are known to trigger a reversible dilated cardiomyopathy referred as arrhythmia-induced cardiomyopathy (AiCM). It remains unclear why some patients are more prone to develop AiCM despite similar arrhythmia burdens. The challenge is to determine whether arrhythmias are fully, partially, or at all responsible for an observed LV dysfunction. AiCM should be suspected in patients with mean heart rate >100 beats/min, atrial fibrillation, and/or premature ventricular contractions burden ≥10%. Reversal of cardiomyopathy by elimination of the arrhythmia confirms AiCM. Therapeutic choice depends on the culprit arrhythmia, patient comorbidities, and preferences. Following recovery of LV function, patients require continued follow-up if an abnormal myocardial substrate is present. Appropriate diagnosis and treatment of AiCM is likely to improve quality of life and clinical outcomes and to reduce hospital admission and health care spending.

    Research areas

  • arrhythmia, cardiomyopathy, heart failure, left ventricular dysfunction, premature ventricular contractions, supraventricular tachycardia

Citation formats


Huizar, J. F., Ellenbogen, K. A., Tan, A. Y., & Kaszala, K. (2019). Arrhythmia-Induced Cardiomyopathy: JACC State-of-the-Art Review. Journal of the American College of Cardiology, 73(18), 2328-2344.


Huizar, JF, Ellenbogen, KA, Tan, AY & Kaszala, K 2019, 'Arrhythmia-Induced Cardiomyopathy: JACC State-of-the-Art Review', Journal of the American College of Cardiology, vol. 73, no. 18, pp. 2328-2344.